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Iranian Neuro-Oncology Group

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To Sum-up the case presented in 7/6/2021:

A 55 years old woman presented with hemifacial numbness... (Click Here)

Dr Gomar: Dr Saleh Mohebbi Presented a very interesting case of intra-extracranial tumor of benign pathology. There is a history of surgery for intracranial part of the tumor and a vague history of tumor growth. According to the pie-chart, most comments are in favor of surgery due to the fact that the tumor has shown a growth and there is a large extracranial part. However, some colleagues have voted for follow-op or radiosurgery. 

To Sum-up the case presented in 6/21/2021:


A 64 year old women presented with mild headache and numbness on the right side of her face. Neurological exam are otherwise normal.in imaging there is a mass in the right cavernous sinus (click here).


Dr Jahanbakhshi: There are 16 comments on this case. According to the pie chart most comments are in favor of surgery and adjuvant treatment followed by radiotherapy alone and surgery alone. According to the neurovascular anatomy of the cavernous sinus, it is very difficult to perform a total resection without neurovascular complication. As it is reviewed in a paper by Maziar Azar and Farid Kazemi et al (you can download it here), microsurgical and radiosurgical series are comparable in terms of tumor control and complication profile. In most radiosurgical series, diagnosis is made solely by radiological exams. So, it is not necessary to have a biopsy from this hazardous area.


Dr Cozzi: According to the literature, stereotactic radiosurgery has agood efficacy for tumor control in meningioma grade I (12-14 Gy in single fraction preserving the optic pathway with a maximum dose of 12 Gy). In this case there is no pathological confirmation. So, Intensity-Modulated RT 54 Gy in 30 fractions (i.e. VMAT) is my recommendation.



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